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2019

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TREATMENT OF ALLERGIC RHINITIS USING MOBILE TECHNOLOGY WITH REAL WORLD DATA: THE MASK OBSERVATIONAL PILOT STUDY

J. Bousquet1,2,3; P. Devillier4; S. Arnavielhe5; A. G. Alexis-Alexandre6; M. van Eerd7; R. Murray8; G. W. Canonica9; M. Illario10; E. Menditto11; G. Passalacqua9; C. Stellato12; M. Triggiani12; Pedro Carreiro-Martins13; João Fonseca14,15; Mário Morais Almeida16; L. Nogueira-Silva17; A. M. Pereira15,18,19; Ana Todo Bom20; I. Bosse21; D. Caimmi22; P. Demoly22; J. F. Fontaine23; J. Just24; G. L. Onorato; M. L. Kowalski25,26; P. Kuna27; B. Samolinski28; J. M. Anto29,30,31,32; J. Mullol16; A. Valero33; P. V. Tomazic34; K. C. Bergmann35; T. Keil36,37; L. Klimek38; R. Mosges39,40; S. Shamai39,40; T. Zuberbier35; E. Murphy41; P. McDowall41; D. Price42,43,44; D. Ryan45; A. Sheikh46; N. H. Chavannes47; W. J. Fokkens48; V. Kvedariene49; A. Valiulis50,51; C. Bachert52; P. W. Hellings3,53,54; I. Kull55; E. Melen55; M. Wickman56,57; C. Bindslev-Jensen58; E. Eller58; T. Haahtela59; N. G. Papadopoulos60,61; I. Annesi-Maesano62,63; M. Bewick64; S. Bosnic-Anticevich65,66; A. A. Cruz67,68; G. De Vries7; B. Gemicioglu69; D. Larenas-Linnemann70; D. Laune5; E. Mathieu-Dupas5; R. E. O’Hehir71,72; O. Pfaar38,73; F. Portejoie1; V. Siroux74; O. Spranger75; E. Valovirta76; O. VandenPlas77; A. Yorgancioglu78

1 - Contre les MAladies Chroniques Pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, MACVIA-France, Montpellier, France
2 - INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Universit_e Versailles St-Quentin-en-Yvelines, UMRS168, Villejuif, Montigny le Bretonneux, France
3 - Euforea, Brussels, Belgium
4 - Laboratoire de Pharmacologie Respiratoire UPRES EA220, P^ole des Maladies Respiratoires, H^opital Foch, Suresnes - Universit_e Versailles Saint-Quentin, Versailles, France
5 - Kyomed, Montpellier, France
6 - EZY, Montpellier, France
7 - Peercode BV, Gerdermalsen, The Netherlands
8 - Medical Communications Consultant, MedScript Ltd, Dundalk, Ireland
9 - Allergy and Respiratory Diseases, Department of Internal Medicine, IRCCS San Martino-IST-University of Genoa, Genoa, Italy
10 - Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
11 - Center of Pharmacoeconomics, CIRFF, University of Naples Federico II, Naples, Italy
12 - Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
13 - Servicio de Imunoalergologia, EPE – Nova Medical School, Respiratory Research Group, CEDOC, Centro Hos pitalar de Lisboa Central, Lisbon, Portugal
14 - Faculdade de Medicina, Center for Health Technology and Services Research-CINTESIS, Universidade do Porto, Porto, Portugal
15 - Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
16 - Rhinology Unit & Smell Clinic, ENT Department, Hospital Clinic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona, Barcelona, Spain
17 - Department of Internal Medicine, Center for Health Technology and Services Research—CINTESIS, Centro Hospitalar Sao Joao, Porto, Portugal
18 - Immunoallergy Department, CUF-Descobertas Hospital, Lisbon, Portugal
19 - Health Information and Decision Sciences Department, Faculty of Medicine of the University of Porto, Porto,Portugal
20 - Imunoalergologia, Centro Hospitalar Universitario de Coimbra, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
21 - Allergist, La Rochelle, France
22 - CHU de Montpellier, UPMC, Paris 06, UMR-S 1136, IPLESP, Equipe EPAR, Sorbonne Universit_es, Paris, France
23 - Allergist, Reims, France
24 - Allergology Department, Centre de l’Asthme et des Allergies, H^opital d’Enfants Armand-Trousseau – INSERM, UMRS 1136, UPMC Univ Paris 06 – Institut Pierre Louis d’Epid_emiologie et de Sant_e Publique, Equipe EPAR, Sorbonne Universit_es, Paris, France
25 - Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland
26 - HARC, Lodz, Poland
27 - Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
28 - Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
29 - ISGLoBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
30 - IMIM (Hospital del Mar Research Institute), Barcelona, Spain
31 - CIBER Epidemiologıa y Salud Publica (CIBERESP), Barcelona, Spain
32 - Universitat Pompeu Fabra (UPF), Barcelona, Spain
33 - Pneumology and Allergy Department Hospital Clınic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, University of Barcelona,Barcelona, Spain
34 - Department of ENT, Medical University of Graz, Graz, Austria
35 - Comprehensive Allergy-Centre-Charit_e, Department of Dermatology and Allergy, Global Allergy and Asthma European Network (GA2LEN), Charit_e Universitatsmedizin Berlin, Berlin, Germany
36 - Institute of Social Medicine, Epidemiology and Health Economics, Charit_e—Universitatsmedizin, Berlin, Germany
37 - Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
38 - Center for Rhinology and Allergology, Wiesbaden, Germany
39 - Institute of Medical Statistics and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
40 - CRI-Clinical Research International-Ltd, Hamburg, Germany
41 - Newcastle OHS, The Newcastle upon Tyne NHS Foundation Hospitals Trust, Newcastle upon Tyne, UK
42 - Observational and Pragmatic Research Institute, Singapore City, Singapore
43 - Optimum Patient Care, Cambridge, UK
44 - Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
45 - Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
46 - Asthma UK Centre for Applied Research, Centre of Medical Informatics, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
47 - Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
48 - Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
49 - Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
50 - Vilnius University Clinic of Children’s Diseases and Public Health Institute, Vilnius, Lithuania
51 - European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
52 - ENT Department, Upper Airways Research Laboratory, Ghent University Hospital, Ghent, Belgium
53 - Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
54 - Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
55 - Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institutet, Stockholm, Sweden
56 - Sodersjukhuset, Sachs’ Children and Youth Hospital, Stockholm, Sweden
57 - Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
58 - Department of Dermatology and Allergy Centre, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
59 - Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
60 - Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children’s Hospital, University of Manchester, Manchester, UK
61 - Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital P&A Kyriakou”, University of Athens, Athens, Greece
62 - EPAR U707 INSERM, Paris, France
63 - EPAR UMR-S UPMC, Paris VI, Paris, France
64 - iQ4U Consultants Ltd, London, UK
65 - Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
66 - Sydney Local Health District, Glebe, NSW, Australia
67 - ProAR—Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil
68 - GARD Executive Committee, Salvador, Brazil
69 - Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
70 - Center of Excellence in Asthma and Allergy, Hospital M_edica Sur, Mexico City, Mexico
71 - Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia
72 - Department of Immunology, Monash University, Melbourne, Vic., Australia
73 - Departent of Otorhinolaryngology, Head and Neck Surgery, Universit€atsmedizin Mannhein, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
74 - INSERM, Universite Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Universit_e Joseph Fourier, Grenoble, France
75 - Global Allergy and Asthma Platform GAAPP, Vienna, Austria
76 - Department of Lung Diseases and Clinical Allergology, Terveystalo, Allergy Clinic, University of Turku, Turku, Finland
77 - Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Universit_e Catholique de Louvain, Yvoir, Belgium
78 - Department of Pulmonology, Celal Bayar University, Manisa, Turkey

Publicação em versão integral em Allergy. 2018 Jan 15. doi: 10.1111/all.13406. [Epub ahead of print]

Resumo:
Background: Large observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect “real‐world” everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real‐life treatment of allergic rhinitis (AR) using mobile technology.
Methods: A mobile phone app (Allergy Diary, freely available in Google Play and Apple App stores) collects the data of daily visual analog scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular, and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries.
Results: A total of 2871 users filled in 17 091 days of VAS in 2015 and 2016. Medications were reported for 9634 days. The assessment of days appeared to be more informative than the course of the treatment as, in real life, patients do not necessarily use treatment on a daily basis; rather, they appear to increase treatment use with the loss of symptom control. The Allergy Diary allowed differentiation between treatments within or between classes (intranasal corticosteroid use containing medications and oral H1‐antihistamines). The control of days differed between no [best control], single, or multiple treatments (worst control).
Conclusions: This study confirms the usefulness of the Allergy Diary in accessing and assessing everyday use and practice in AR. This pilot observational study uses a very simple assessment (VAS) on a mobile phone, shows novel findings, and generates new hypotheses.